Pulled Calf Muscle aka Calf Strain

A pulled calf muscle is a really common sporting injury that can cause long-term problems if not effectively managed. Other common terms for the condition include a calf muscle strain or torn calf muscle.

Essentially, what all these terms refer to is one of the calf muscles being pulled beyond its normal elastic limit, overstretching it and damaging some or all of muscle fibers.

With a calf strain there is usually sudden, intense
pain, the area may be tender to touch with swelling and bruising and walking
is often difficult. There are three
grades of calf muscle strain, depending on how much of the muscle is damaged.

The Calf Muscles

The calf is made up of two muscles, gastrocnemius and soleus.

The deep soleus muscle arises from just below
the knee joint. The gastrocnemius muscle sits over the top of the soleus muscle
and arises from just above the knee.
Both muscles join together around the mid-calf level to form the
Achilles tendon which attaches the calf to the foot at the back of the
heel.

The calf muscles work together to pull the foot downwards
into plantarflexion. They play an
important role when the foot is pushing off the ground when walking, running
and jumping and help to stabilise the ankle.

Causes of Calf Muscle Strain

A pulled calf muscle usually happens suddenly due to
injury, but can develop gradually from overuse.
A calf muscle strain most
commonly affects the larger, more superficial gastrocnemius muscle but can
affect the soleus muscle as well.

Acute calf muscle strains occur when the muscle is suddenly overstretched,
usually when changing direction or accelerating e.g. sprinting or jumping. Athletes participating in sports such as
tennis, basketball, football or track events are commonly affected by calf
muscle strain due to the sudden bursts of speed required when moving from a
stationary position.

Calf muscle strains can also developed due to repetitive overuse of
the calf muscles usually with running and jumping, especially if the muscles
are weak or tight. Pulled calf muscles
are the most common cause of calf pain in runners.

Calf Strain Symptoms

There are three grades of calf muscle strain:

Grade 1: This is when a torn calf muscle affects only a few of
the muscle fibres (up to approximately 10%)Symptoms: Mild pain may be felt at the time of injury or may not develop until
after activity has stopped. The calf may
feel tight and painful to move and it may be accompanied by cramp. Symptoms usually last from a few days to a
couple of weeks

Grade 2: More fibres are damaged but the muscle is still
intact (10-90% of the muscle fibres) Symptoms: With a grade 2 pulled calf muscle a moderate, sharp pain is usually
felt at the time of injury and there may be resultant swelling and
bruising. It will be painful when the
calf muscles contract or are stretched and the region is often tender to touch. The affected person will usually walk with a
limp due to pain and weakness. Symptoms
usually last 4-6 weeks

Grade 3: Complete rupture of the muscle i.e. all the fibres
are torn.Symptoms: When suffering from a completely torn calf muscle, pain will be
severe and immediate. The person will be
unable to walk on the affected leg. There
will be considerate bruising and swelling.
There may also be a bulge in the calf just above where the rupture has
taken place as the muscle tissue pings up into a lump

Treatment For A Pulled Calf Muscle

Treatment for a pulled calf muscle aims to prevent further
injury, aid healing and ensure full recovery to prevent long-term problems.

1) Rest

The most important treatment for a pulled calf muscle is
rest. It sounds simple, but it is vital
to rest to allow the muscles to heal and to prevent the injury getting
worse. Returning to activity too soon can
turn a grade 1 torn calf muscle into a grade 2 or a grade 2 to a grade 3.

You will probably need to rest for 2-3 weeks
with a grade 1 calf muscle strain, longer for a more severe injury. Avoid
any activities that cause pain and do not stretch the muscle. You should not return to sport until you are pain free. Stretching should be avoided until
you can plantarflex your foot against resistance without pain e.g. pushing up
onto your tiptoes. Do not return to
sport until you have been given the all clear by your doctor or physical
therapist

Ice should be applied to a pulled calf muscle as quickly as
possible. Either use a specially
designed ice pack or wrap ice cubes in a towel and place them over the affected
area for 10 minutes. Leave 2 hours between
applications. To find out more about how
to use ice safely and effectively, visit the ice treatment section.

Wearing a compression bandage such a tubigrip or a specially
designed calf wrap will help to reduce swelling and provide some support to the
pulled calf muscle. The compression helps to limit swelling
by reducing blood flow. Tubigrip should
not be worn at night.

4) Elevation

Keep the injured calf elevated above the level of the heart
to help reduce swelling associated with a pulled calf muscle. Ensure that the
back of the knee is supported when in this position to prevent knee pain.

5) Medication

Your doctor may advise medication to help reduce the pain
and inflammation associated with a pulled calf muscle. Over the counter medication such as
paracetamol/acetaminophen or ibuprofen/Advil is usually sufficient. Always consult your doctor before taking any
medication.

6) Crutches

You may need to use crutches for a few days to keep the
weight off your leg and prevent further damage to the strained calf muscle. These should be provided by a health care profession to ensure they are the right height and so they can teach you how to safely move around and go up and down stairs.

Wearing a heel pad in your shoe helps to raise the heel and therefore
decreases the tension through the calf muscle.
It is best to wear a pad in both shoes otherwise you will end up with
one leg slightly longer than the other which can lead to back problems.

Once the pain from your pulled calf muscle is settling, you
can start gentle movement and strengthening exercises. These should be carried out under the
guidance of your doctor or physical therapist.
Any exercises that cause pain should be stopped immediately. When appropriate,
resistance exercises e.g. using theraband are important as they help the fibres
to align properly as they heal and prevent the build-up of scar tissue. Once these are pain-free, you can start calf stretching exercises.

It is important to
continue rehab even once the symptoms have gone to ensure you regain full strength
and flexibility in your calf muscles or you run the risk of suffering from
further pulled calf muscles in the future.

9) Sports Massage

A sports massage, carried out by a fully trained
professional can aid healing of a pulled calf muscle by improving blood flow,
stretching the muscle and preventing the build-up of scar tissue.

10)
Ultrasound

Your physical therapist may also use ultrasound to help
promote healing after a pulled calf muscle. It is thought that
Ultrasound can help to improve blood flow to the area and breakdown any cross-fibres
that have formed in the muscle allowing the collagen fibres to heal in the
correct alignment to ensure good strength and flexibility in the muscle.

Preventing Calf Strains

Whether you have suffered from a pulled calf muscle in the past or not, prevention is better than cure. By ensuring that your muscles are warmed up before commencing exercise, you reduce your risk of suffering from a calf muscle strain.

You also want to make sure you calf muscles are strong and flexible so that they can cope with strain you put them through:

1) Strengthening Exercises: exercises to improve the strength and endurance of the calf muscles will reduce the chance of injury2) Stretching Exercises: regularly stretching your calf muscles, especially before and after exercise reduces the strain on the muscle and improves flexibility.

To find out how to effectively strengthen and stretch your calf muscles, visit the calf workout section on our sister site

A pulled calf muscle is the most common cause of calf pain, but there are other, potentially life threatening causes of calf pain. Visit the calf pain section to find out more.

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